| NPI | 1497237101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINA PAGE Sole Proprietor 843-267-8885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5658) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2018-08-30 |